Two-Stage Revision Using a Modified Articulating Spacer in Infected Total Knee Arthroplasty

bone loss, and impaired postoperative rehabilitation and func-tional recovery due to restriction on weight-bearing between the two stages3). The introduction of articulating prosthesis with antibiotic-loaded acrylic cement (PROSTALAC; DePuy Orthopaedics Inc., Warsaw, IN, USA) has contributed to reduced infection rates and increased range of motion (ROM). Unfortunately, it is neither affordable nor applicable to all patients4,5). Thus, some studies suggested using articulating prostheses that are manufactured intraoperatively by the surgeon6,7). The custom-made spacers are described as facilitating the procedure, allowing for early ambula-tion and minimal soft tissue contractures, and yielding favorable outcomes in terms of preservation of the muscle strength and ROM. Still, prolonged use of such prostheses has been associated with quadriceps contractures and joint capsule adhesion in two-stage revision. Hence, efforts have been focused on inventing temporary articulating spacers for two-stage revision arthroplas-ty. In this article, we present our experience of two-stage revision TKA using a modified articulating spacer that was effective for facilitating joint mobility and eradicating infection with a revie